Application for Employment Kurtis Chevrolet Inc. If not filled out completely, your application will not be considered.

Transcription

1 Application for Kurtis Chevrolet Inc. If not filled out completely, your application will not be considered.

2 APPLICATION FOR EMPLOYMENT PRE-EMPLOYMENT QUESTIONNAIRE EQUAL OPPORTUNITY EMPLOYER Date Position Desired Full Time Salary Desired Available Date Part Time WE ARE AN EQUAL OPPORTUNITY EMPLOYER APP ICA A E E I understand that this application is not a promise of employment. If I am hired, my employment will be for no definite peri od, such that I have the right to terminate my employment at any time with or without notice, and the Company has the same right. No one other than the Pre sident of the Company has authority to modify this relationship or to make any agreement to the contrary, and any such agreement or modification must be in writing. I understand that the company reserves the right to require me to submit to medical examinations and drug/alcohol tests, prio r to and during employment, as permitted by law. I also understand that I may be required to take other tests, such as personality and honesty tests, prior to and during my employment, as permitted by law. I authorize the Company to investigate my background, character, reputation, personal characteristics, driving record, emp loyment history, and criminal record, including obtaining investigative reports, as permitted by law. I expressly authorize all individuals with such know ledge to release information to C y, I in, my prior employers, and all individuals associated with them. I hereby fully waive any and all claims arising directly or indirectly from such disclosures and their use, whether the disclosures are favo rable or unfavorable to me. I hereby state that all the information that I have provided on this application, and all information I will provide in the application, intervie w and hiring process will be true and accurate. If I am employed and any such information is later found to be false in any respec t, I may be dismissed. DO NOT SIGN UNTIL YOU HAVE READ THE ABOVE STATEMENT Signature of Applicant PERSONAL DATA (Please Print) LAST NAME FIRST NAME MIDDLE INITIAL SOCIAL SECURITY NUMBER HOME TELEPHONE NUMBER PRESENT ADDRESS CELL PHONE NUMBER CITY STATE ZIP HOW LONG AT THIS ADDRESS? PREVIOUS ADDRESS CITY STATE ZIP HOW LONG AT THIS ADDRESS? WHO REFERRED YOU TO THIS COMPANY? EMPLOYMENT AGENCY NEWSPAPER FRIEND EMPLOYEE STATE EMPLOYMENT AGENCY WALK IN INTERNET OTHER (DESCRIBE) Are you 18 years of age or older? Have you ever worked for this Company before? If yes, please give dates and position: Do you have any friends or relatives working here? If yes, Name: Relationship: Do you have a means of transportation that will allow you to consistently arrive at work on time? I SPECIFIC position for y y, y? License No. State Issued Exp. Date If the position you seek may involve operating a motor vehicle, have you been found guilty of a traffic violation of any kind within the last FIVE years? If yes, please give date and details. Have y y? N : A y constitute an automatic bar to employment. If yes, give date and details of each: NOTE: A separate FCRA form must be executed to obtain investigative reports from third parties about an applicant. Some states prohibit questions about criminal history, such as those which have been expunged. Consult the rules of the states in which you operate prior to asking questions about tory. To reorder: Specify Item #820 Form EMP-1 Revised (10/11)

3 EDUCATION High School College/University Graduate / Professional School Name Years completed: Choose # of years. Choose # of years. Choose # of years. Diploma / Degree Describe course of study or major Describe Specialized Training, Military Experience, Special Computer Certifications and/or Skills pertaining to the position for which you are applying GENERAL INFORMATION Can you provide documentation that you have the right to work in the United States? List all computer programs in which you are proficient (if applicable to the job you seek): (For additional information use separate sheet) (Your Initials) Can you type (if applicable to the job you seek)? If yes, please provide your average speed: words per minute. Are you available to work weekends and evenings if necessary? Are you capable of performing the essential job functions of the position for which you are applying, with or without reasona ble accommodation of any disability? Can you meet the SPECIFIC attendance requirements of the job for which you are applying? Did you have any authorized absences from your last job? Do you currently use illegal drugs? Have you ever been convicted for the use, sale, or possession of illegal drugs? Note: Some states prevent questions about marijuana convictions and minor drug related offenses. Have you submitted any letters of recommendation you may have from previous employers? Additional comments concerning above information: EMERGENCY INFORMATION In case of an accident or other emergency, who should we contact? Name: Home Address: Home Address: Street City State Street City State Relationship: : :

4 RECORD OF PREVIOUS EMPLOYEMENT Please list the names of your previous employers in chronological order with present or last employer listed first. Be sure to account for all periods of time including military service and any period of unemployment. If self-employed, give firm name and supply business references. Address Address January 01 January 01 January 01 January 01 J J Have you ever been involuntarily terminated or asked to resign from any job? If yes, please explain the circumstances: Please explain fully any gaps in your employment history: May we contact your current employer? If no, please explain:

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